Medicina
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Observational Study
Amikacin Liposomal Inhalation Suspension for Non-Tuberculous Mycobacteria Lung Infection: A Greek Observational Study.
Background and Objectives: Intravenous amikacin, recommended for severe or recurrent M. avium complex (MAC) infections and as initial treatment for M. abscessus lung disease, is often limited by serious adverse effects such as renal and auditory toxicities. Inhaled Amikacin Liposome Inhalation Suspension (ALIS) enhances pulmonary drug deposition while minimizing systemic adverse effects, and it has recently been introduced as an add-on therapy for refractory MAC infections or when other standard treatments are inadequate. This study aims to retrospectively describe the outcomes of Greek patients with difficult-to-treat non-tuberculous mycobacterial (NTM) lung disease following the addition of ALIS to guideline-based therapy. ⋯ The most frequent adverse effects related to ALIS were mild and localized to the respiratory tract, with only one patient discontinuing therapy due to hypersensitivity pneumonitis. Conclusions: Adding ALIS to standard regimens was effective and safe in a small group of Greek patients with refractory or recurrent NTM lung disease, particularly those who had discontinued intravenous aminoglycosides due to significant adverse effects, with notable responses observed in MAC lung disease. Further research is needed to validate these findings in clinical practice and to investigate ALIS's role in NTM lung disease caused by other species.
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Background and Objectives: Perceived health status (PHS) is associated with various health outcomes in older adults, but its relationship with resilience in the context of events with a major impact on functional status (FS), such as hip fracture, has not been explored. Our objective was to evaluate whether older adults who report good PHS before a hip fracture have a higher probability of returning to their baseline physical performance (PP) and personal independence. Materials and Methods: We analyzed data from waves 1 and 2 of the Survey of Health, Ageing and Retirement in Europe (SHARE) study, enrolling patients ≥ 65 years who experienced a hip fracture between these two waves. ⋯ After adjustment, the risk of worsening PP in participants with good PHS was reduced by 34% (95% CI: 0.41-1.06). Conclusions: A simple question on PHS may predict the resilience of older adults after an acute stressor. A systematic evaluation of PHS can help identify patients with a higher probability of regaining function after a hip fracture and thus provide useful information for resource allocation.
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Case Reports
Immediate Loading Full-Arch 3D-Printed Implant-Supported Fixed Rehabilitation: A Case Report with 24-Month Follow-Up.
Implant-supported immediate loading full-arch rehabilitation has been documented in the literature. More recently, computed surgical guides have frequently been used since they facilitate planning and performing surgical treatment without the need to raise a flap, thus reducing trauma and morbidity. This case report describes an immediate full-arch, fixed rehabilitation with full loading placed on four commercially available 3D-printed implants, with a 24-month follow-up. ⋯ The same situation was observed at the 24-month follow-up. Three-dimensional-printed implants seem to be a promising choice in this case. However, further clinical studies with longer follow-up periods are necessary to confirm their efficacy.
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Background: Diabetic retinopathy (DR) is a leading cause of blindness in patients with type 2 diabetes mellitus (T2DM). Cardiovascular risk factors, such as hypertension, obesity, and dyslipidemia, may play a crucial role in the development and progression of DR, though the evidence remains mixed. This study aimed to assess cardiovascular risk factors as independent predictors of DR and to develop a predictive model for DR progression in T2DM patients. ⋯ After tuning, the XGBoost model showed a notable improvement, with an ROC-AUC of 0.72. Conclusions: Cardiovascular risk factors, particularly BP and BMI, play a significant role in the progression of DR in patients with T2DM. The predictive models, especially XGBoost, showed moderate accuracy in identifying DR stages, suggesting that integrating these risk factors into clinical practice may improve early detection and intervention strategies for DR.
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Background and Objectives: The deltopectoral (DP) flap represents a reconstructive option for the head and neck. It is a fasciocutaneous flap raised from the anterior chest wall below the clavicle. Its role partially declined with the arise of free flaps. ⋯ Conclusions: The DP has a wide range of applications in head and neck reconstruction, and a low complication rate can be observed. The delayed technique does not necessarily need to be applied, and the flap can be extended beyond the deltopectoral groove when necessary. However, patients with diabetes mellitus have a higher risk of postoperative necrosis of the distal portion of the flap.